Arm and leg injuries were most commonly seen – with fractures making up 27.5 percent of the injuries. Children under five were more likely to have fractures while teenagers were more likely to have sprains and strains. Hospitalization was required for 3.4 percent of injured children.

So how are kids getting hurt?

Well, they are either jumping on top of each other, landing on their own twisted arms and legs, or falling out of the bounce houses, which results in fractures and sprains. In one incident, a 3-year-old suffered facial bruising when a bounce house deflated.

The study’s leader author, Dr. Gary Smith, says there is no hard evidence to explain why the number of injuries is going up, but increased use could be to blame.

1. Based on developmental abilities, don’t let children under the age of 6 play in these inflatable devices.

2. Having one child play at a time is the safest, but that’s not very realistic (or much fun), so only have children of similar age and size play inside these bouncers at one time.

3. Horseplay, flips and somersaults should be prohibited; that kind of play leads to the most dangerous injuries.

4. Always have an adult present when these devices are in use — but not inside with the children. Adults (parents and/or bounce center operators) should be in a position to observe and intervene if children are engaging in horseplay or doing flips and somersaults.